A promising concept of combination therapy for positional obstructive sleep apnea

被引：92
作者：
Dieltjens, Marijke [1 ,2 ,3 ,7 ]
Vroegop, Anneclaire V. [2 ,3 ,7 ]
Verbruggen, Annelies E. [2 ,3 ,7 ]
Wouters, Kristien [4 ]
Willemen, Marc [5 ]
De Backer, Wilfried A. [5 ,6 ,7 ]
Verbraecken, Johan A. [5 ,6 ,7 ]
Van de Heyning, Paul H. [2 ,3 ,5 ,7 ]
Braem, Marc J. [1 ,7 ]
de Vries, Nico [2 ,3 ,7 ,8 ]
Vanderveken, Olivier M. [2 ,3 ,5 ,7 ]
机构：
[1] Antwerp Univ Hosp UZA, Dept Special Care Dent, B-2650 Edegem, Belgium
[2] Antwerp Univ Hosp UZA, ENT Dept, Edegem, Belgium
[3] Antwerp Univ Hosp UZA, Head & Neck Surg, Edegem, Belgium
[4] Antwerp Univ Hosp UZA, Sci Coordinat & Biostat, B-2650 Edegem, Belgium
[5] Antwerp Univ Hosp UZA, Multidisciplinary Sleep Disorders Ctr, B-2650 Edegem, Belgium
[6] Antwerp Univ Hosp UZA, Pulm Med, B-2650 Edegem, Belgium
[7] Univ Antwerp, Fac Med & Hlth Sci, B-2020 Antwerp, Belgium
[8] Sint Lucas Andreas Hosp, Dept Otolaryngol Head & Neck Surg, Amsterdam, Netherlands
来源：
SLEEP AND BREATHING | 2015年 / 19卷 / 02期
关键词：
Obstructive sleep apnea/hypopnea syndrome; Sleep-disordered breathing; Supine-dependent; ORAL APPLIANCE THERAPY; MANDIBULAR ADVANCEMENT DEVICES; AIRWAY PRESSURE; PREVALENCE;
D O I：
10.1007/s11325-014-1068-8
中图分类号：
R74 [神经病学与精神病学];
学科分类号：
摘要：
The objective of this randomized controlled trial was to assess the additional effect of a chest-worn sleep position trainer (SPT) in patients with residual supine-dependent obstructive sleep apnea (sdOSA) under mandibular advancement device (MAD) therapy. Baseline and follow-up polysomnography with MAD were performed. Twenty patients with sdOSA under MAD therapy underwent two consecutive randomized polysomnographies: one with SPT and one with combination of SPT + MAD. Data are presented as median (quartile 1, quartile 3). The SPT reduced the time spent in supine sleeping position compared to baseline and MAD therapy. Both MAD and SPT were individually effective in reducing the overall apnea/hypopnea index (AHI) significantly when compared to baseline from 20.8 (15.1; 33.6)/h at baseline to 11.0 (6.7; 13.8)/h and to 11.1 (3.5; 17.7)/h with MAD or SPT, respectively. The combination of SPT + MAD further reduced the overall AHI to 5.7 (3.6; 7.4), which was significantly lower than with MAD alone (p < 0.001) and SPT alone (p < 0.008), respectively. The results of this study indicate that combination of SPT + MAD leads to a higher therapeutic efficacy in patients with sdOSA under MAD therapy when compared to one of the treatment modalities alone.
引用
收藏
页码：637 / 644
页数：8
相关论文
共 30 条
[21]   Mandibular advancement devices -: Rate of contrainclications in 100 consecutive obstructive sleep apnea patients [J].
Petit, FX ;
Pépin, JL ;
Bettega, G ;
Sadek, H ;
Raphaël, B ;
Lévy, P .
AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, 2002, 166 (03) :274-278
[22]   The undervalued potential of positional therapy in position-dependent snoring and obstructive sleep apnea-a review of the literature [J].
Ravesloot, M. J. L. ;
van Maanen, J. P. ;
Dun, L. ;
de Vries, N. .
SLEEP AND BREATHING, 2013, 17 (01) :39-49
[23]   Mandibular advancement oral appliance therapy for obstructive sleep apnoea: effect on awake calibre of the velopharynx [J].
Ryan, CF ;
Love, LL ;
Peat, D ;
Fleetham, JA ;
Lowe, AA .
THORAX, 1999, 54 (11) :972-977
[24]  
Safiruddin F, 2014, LARYNGOSCOPE, DOI [10. 1002/ lary-24598, DOI 10.1002/LARY-24598]
[25]   Oral Appliance Treatment for Obstructive Sleep Apnea: An Update [J].
Sutherland, Kate ;
Vanderveken, Olivier M. ;
Tsuda, Hiroko ;
Marklund, Marie ;
Gagnadoux, Frederic ;
Kushida, Clete A. ;
Cistulli, Peter A. .
JOURNAL OF CLINICAL SLEEP MEDICINE, 2014, 10 (02) :215-227
[26]   Evaluation of the impact of a clinical pathway on the organization of a multidisciplinary dental sleep clinic [J].
Ten Berge, D. M. ;
Braem, M. J. ;
Altenburg, A. ;
Dieltjens, M. ;
Van de Heyning, P. H. ;
Vanhaecht, K. ;
Vanderveken, O. M. .
SLEEP AND BREATHING, 2014, 18 (02) :325-334
[27]   Long-Term Effectiveness and Compliance of Positional Therapy with the Sleep Position Trainer in the Treatment of Positional Obstructive Sleep Apnea Syndrome [J].
van Maanen, J. Peter ;
de Vries, Nico .
SLEEP, 2014, 37 (07) :1209-1215
[28]   The sleep position trainer: a new treatment for positional obstructive sleep apnoea [J].
van Maanen, J. Peter ;
Meester, Kristel A. W. ;
Dun, Lideke N. ;
Koutsourelakis, Ioannis ;
Witte, Birgit I. ;
Laman, D. Martin ;
Hilgevoord, Antonius A. J. ;
de Vries, Nico .
SLEEP AND BREATHING, 2013, 17 (02) :771-779
[29]   Comparison of a custom-made and a thermoplastic oral appliance for the treatment of mild sleep apnea [J].
Vanderveken, Olivier M. ;
Devolder, Annick ;
Marklund, Marie ;
Boudewyns, An N. ;
Braem, Marc J. ;
Okkerse, Walter ;
Verbraecken, Johan A. ;
Franklin, Karl A. ;
De Backer, Wilfried A. ;
Van de Heyning, Paul H. .
AMERICAN JOURNAL OF RESPIRATORY AND CRITICAL CARE MEDICINE, 2008, 178 (02) :197-202
[30]   Objective measurement of compliance during oral appliance therapy for sleep-disordered breathing [J].
Vanderveken, Olivier M. ;
Dieltjens, Marijke ;
Wouters, Kristien ;
De Backer, Wilfried A. ;
Van de Heyning, Paul H. ;
Braem, Marc J. .
THORAX, 2013, 68 (01) :91-96
123